As cancer treatments continue to advance and survival rates go up for many different types of cancer, healthcare professionals must now consider a patient’s quality of life (QoL) not just during treatment, but also after surviving the disease. Following such a traumatic experience, what outside factors may be affecting their QoL?
One thing to consider is employment and occupational status. The experience of cancer diagnosis and treatment is fraught enough without the added stress and financial pressures of infrequent employment. Understanding how occupational status can affect the mental health of your patients both during and after treatment is crucial to understanding how their QoL may change.
Employment and Patients With Cancer
A patient’s occupational status, job satisfaction, and job-related stress all play a role in their QoL as they face cancer treatment. A 2020 study in Cancer Epidemiology, Biomarkers and Prevention examined employment status in young women diagnosed with breast cancer and found that it created a number of hardships.¹
Of the 830 women recruited for the study, 73.4% were employed at the time of diagnosis, and 47.3% saw an increase in unpaid time off. In addition, 23.2% of participants reported a decrease in job performance and 23.5% reported that they would not change jobs because of their health insurance. Over 9% of respondents said the price of their insurance coverage was higher than expected.
In addition to retaining a salary, maintaining a sense of normalcy by having employment may also be beneficial. A 2013 study in Psychooncology found that among participating women recently diagnosed with breast cancer, working 1 to 19 hours a week was beneficial to their well-being and QoL.² Women working 20 or more hours per week were found to have a greater functional well-being than those who were not working. Working in an environment that is not overly strenuous or stressful had benefits to their physical and social well-being.
Employment and Cancer Survivors
Cancer survivors have a lot to contend with following treatment, and financial hardships can negatively affect their QoL. A 2018 study in the Journal of Clinical Oncology found that family and financial burden was associated with a lower QoL in cancer survivors.³ Over a third of the participants reported decreased work hours, while 26.8% lost or changed jobs. The researchers also noted that marital status changes were higher in the participants who experienced these variations in their work.
This stress and uncertainty can be incredibly detrimental to a patient’s mental state. A recent study published in the International Journal of Environmental Research and Public Health, examined the health-related QoL of cancer survivors based on their occupational status. The researchers found that suicidal ideation and depressive symptoms were significantly higher in patients who weren’t working compared to those who were.⁴ These factors were highly associated with a decreased QoL.
Healthcare professionals in oncology should be aware of the societal factors that may make a patient less likely to have employment, such as low income and education levels.⁴ The researchers also found that male cancer survivors were more likely to be employed than female survivors. Those without work deemed their own health status as poor. Occupational status, along with social and family support, were seen as primary variables in QoL in these survivors.
1. Tangka FK, Subramanian S, Jones M et al. Insurance coverage, employment status, and financial well-being of young women diagnosed with breast cancer. Cancer Epidemiol Biomarkers Prev. 2020;29(3):616-624. doi:10.1158/1055-9965.epi-19-0352
2. Timperi AW, Ergas IJ, Rehkopf DH, Roh JM, Kwan ML, Kushi LH. Employment status and quality of life in recently diagnosed breast cancer survivors. Psychooncology. 2013;22(6):1411-1420. doi:10.1002/pon.3157
3. Remolina Bonilla Y, Armengol Alonso A, Trejo Rosales R. Impact of quality of life on employment and marital status in long-term cancer survivors treated in a referral center in Mexico. J Clin Oncol. 2018;36(7_suppl):122-122. doi:10.1200/jco.2018.36.7_suppl.122
4. Kim K, Yoon H. Health-Related quality of life among cancer survivors depending on the occupational status. Int J Environ Res Public Health. 2021;18(7):3803. Published 2021 Apr 6. doi:10.3390/ijerph18073803
This article originally appeared on Oncology Nurse Advisor